Eustachian tubes, which open behind the nose and on both sides of the nasal cavity, ensure that the pressure in the middle ears is equalized with the outside air pressure and provides ventilation. As a result of dysfunctions of the Eustachian canal due to various reasons, negative pressure occurs in the middle ear as a result of the air in the middle ear being absorbed by the mucosa lining the middle ear and mastoid cells (air cells in the ear bone). While the short duration of the dysfunction causes the fluid in the tissues to collect in the middle ear cavity due to the negative pressure (serous otitis media), if the problem becomes chronic, the consistency of the accumulated fluid gradually thickens due to the increased mucus secretion glands in the middle ear mucosa (secretory otitis media). At the same time, the pulling of the eardrum towards the middle ear due to negative pressure may result in collapse of the membrane and adhesion of the membrane to the auditory ossicles in the middle ear and the middle ear base in the long term (Adhesive otitis).
Failure to recognize and correct these complications in time may lead to permanent hearing loss or While it can cause serious middle ear infections, conductive hearing loss that occurs from the stage of serous otitis has a negative impact on speech and mental development, especially in developing children.
Despite medical treatments given in the appropriate content and duration, negative pressure and fluid in the middle ear. In order to prevent negative air pressure in the middle ear in patients whose accumulation is not positive, it is necessary to make a hole in the eardrum and allow air to come from the outside environment. These surgically opened holes usually heal and close within 7-10 days, and the problem recurs in cases where this period is not sufficient for the disease in the mucosa to heal.
Especially in cases of chronic fluid accumulation lasting more than 3 months and in cases where the consistency of the accumulated fluid is thick, the opening to the membrane is closed. It is necessary to ensure ventilation in sufficient time by placing a ventilation tube in the hole. Following this procedure, the collapse of the membrane is corrected (in ears without adhesion) and hearing loss quickly returns to normal. In addition, removing the adenoid and tonsils (if they need to be removed) in the same surgery has a positive effect on the long-term effect of the treatment.
The season in which the surgery is performed depends on the patient's, ear and Considering the characteristics of the fluid accumulated in the middle ear, one of the tube types that falls out spontaneously or remains on the membrane until the doctor removes it can be preferred.
The application of a ventilation tube to the eardrum is performed on children under general anesthesia. The tubes, which are placed under a microscope in an approximately 10-minute surgery (only for tube application), generally remain in the eardrum for 6-12 months and then fall out on their own or are removed by the doctor.
After completing the 4-6 month period, the tubes that do not fall out are removed. The late spring periods are generally preferred for this. After the tubes are removed, the holes in the membranes close within 2-3 weeks. Due to the decrease in infections in the summer period, the possibility of recurrence of the disease decreases, and the patient's quality of life is improved by eliminating the need for ear protection. In patients whose 6-month period coincides with the end of summer, it may be preferable to wait until the next spring to remove the tubes.
Allergy and immune system functions should be evaluated, especially in children with recurrent serous otitis complaints. In patients whose eustachian function does not improve, the tubes may need to remain in the ear for many years. There are different types of tubes produced for this type of patients.
There is generally no harm in children with tubes attached to their eardrums going into the sea in areas where the water is clean, as long as they do not dive. Especially in swimming pools and when taking a shower or bath with soapy water, the external ear canal should be closed with Vaseline cotton or a suitable earplug to prevent water from entering the middle ear from the tube through the external ear canal. In case of infection and discharge due to water leakage, the disease can be easily controlled with appropriate medications given orally or through the ear.
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